Kissing stent placement to treat severe bilateral stenosis in pulmonary arteries of 9-year-old boy, for the first time ever worldwide

Panagiotis, 9, was born with complex congenital heart disease and had already undergone three open-heart surgeries to treat it. 

Two years after the last procedure, the doctors identified: 1) Severe stenosis of the main pulmonary artery before its bifurcation, 2) Very severe long stenosis of the left pulmonary artery and 3) Moderate stenosis of the right pulmonary artery. Due to the main pulmonary artery being short, it rendered the placement of a central stent within it impossible, due to the risk of destroying the pulmonary valve. At the same time, the presence of an aneurysm in the right ventricle, very close beneath the surface of the sternum, rendered extremely difficult performing a new sternotomy, for a 4^th consecutive open-heart procedure. 

Once the Pediatric Cardiology and Cardiac Surgery Clinic studied the imaging findings, it was decided that the young patient would undergo non-surgical opening of the pulmonary artery and the two branches, using the kissing-stenting technique. This technique is often used to open the ascending aorta bifurcation and sometimes to open the coronary artery bifurcation. This is the very time ever globally that it was successfully used on the pulmonary arteries. The diameter of the main artery increased from 8 to 18 mm (220%), of the right pulmonary artery from 4 to 10 mm (250%) and of the left pulmonary artery from 2 to 8 mm (400%). The state-of-the-art stents used can be further dilated in the future with a simple balloon, so as to respond to the growth of the young patient, this way limiting the chance of a future open-heart procedure. 

The procedure was performed by the specialized and experienced team of the IASO Children's Hospital Pediatric Cardiology Department and Cardiac Catheterization Lab, headed by Dr. Georgios Tsaousis, and under the scientific guidance of Associate Professor Vasileios Thanopoulos, as well as the support of Mr. Paris Agios, Scientific Associate and Anesthesiologist at IASO Children's Hospital. The IASO Children's Hospital Pediatric Cardiac Surgery Department, headed by world-renowned Professor Afksendiyos Kalangos, took over the cardiac surgery part of the procedure. 

At IASO Children's Hospital, we always make sure that the health of your children is in the best of hands. The experienced medical staff, qualified nursing staff, modern facilities, cutting-edge technology and application of innovative diagnostic and treatment methods make IASO Children's Hospital the leading Pediatric Hospital in Greece.